WVG_F2F_Final_English

COMM and TTC Face to Face Workshops July of 2016
Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala i
Report on Face-to-Face Workshops for Community
Health Committees & Timed Targeted Counseling
Mother Guides
Child Health and Nutrition Impact Study (CHNIS)
World Vision Guatemala
Paola Peynetti Velázquez
Global Health Fellow, World Vision Guatemala
Master of Public Health (MPH) candidate, Boston University
Guatemala, July of 2016

Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala ii
TABLE OF CONTENTS
I. Executive Summary..................................................................................................... iii
II. Acronyms...................................................................................................................... v
III. List of Tables and Graphs…..................................................................................... vi
1. Introduction............................................................................................................... 2
2. Objectives................................................................................................................... 4
3. Content and Methodology of COMM Workshop..................................... 5
3.1 Demographic Mapping.......................................................................................... 5
3.1.1 Introduction to Demographic Mapping............................................. 5
3.1.2 Strengths and Weaknesses of the Process........................................ 6
3.1.3 Lessons Learned....................................................................................... 6
3.1.4 Analysis of Mapping Data for Pregnant Women.............................. 7
3.1.5 Antenatal Care Attendance................................................................... 8
3.1.6 Analysis of Mapping Data for Children Under 24 Mo..................... 9
3.2.COMM Action Plans ........................................................................................... 11
3.2.1 Introduction to Action Plans.................................................................. 11
3.2.2 COMM Action Plans............................................................................... 12
3.2.3 Conclusions from Action Plans…....................................................... 17
3.3 Lessons Learned and New Strategies from COMM F2F............................ 18
3.3.1 Introduction to Lessons Learned........................................................ 18
3.3.2 ¿What Did We Learn and How Will We Improve?........................ 19
3.3.3 Conclusions............................................................................................... 22
3.4 Focus Group.......................................................................................................... 22
4. TTC Workshop: Content and Methodology....................................... 23
4.1 Overview of Activities......................................................................................... 23
4.1.1 Demographic Mapping .......................................................................... 23
4.1.2 Monitoring and Supervision Tools..................................................... 23
4.1.3 Overview of TTC Basics........................................................................ 24
4.2 Lessons Learned and New Strategies for COMM.......................................... 25
4.2.1 Introduction to lessons learned........................................................... 25
4.2.2 ¿What did we learn and how will we improve?............................... 25
4.2.3 Conclusions and take-home points.................................................... 25
5 Conclusions and Recommendations.................................................. 26
6 Index of Annexes………………………………………………………… 27

Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala iii
EXECUTIVE SUMMARY
Since 2012, World Vision Guatemala (WVG) has been part of an initiative called the
Child Health and Nutrition Impact Study (CHNIS), a multicentric research project conducted in
Guatemala, Kenya, Cambodia, and Zambia. In Guatemala, this research study is being conducted
alongside Johns Hopkins University and the Institute of Nutrition of Central America and
Panama (INCAP in Spanish).
CHNIS is implemented through the Central Package of Interventions (CPI), which is
comprised of three models of development: Community Health Committees (COMM), Timed
Targeted Counseling (TTC), and Citizen Voice and Action (CVA). These models have been
implemented in different contexts: in the Central Zone of the country, in the municipalities of
San Raymundo and San Juan Sacatepéquez, and in the Eastern Zone in the municipalities of
Comapa and Jutiapa. This process has encompassed the contextualization and adaptation of the
different models, which has enriched the capacity building process of both the committee
volunteers and the mother guides (MGs) who implement the TTC methodology.
The models adaptation process, once the volunteers have been trained, highlights and
conveys volunteer empowerment on local community organizing, activism, partnerships, and
representation, all of which ultimately benefit the volunteers’ families and communities.
Up until the summer of 2016, the volunteers’ workplans and successes had not been
shared with other COMM groups, MGs or WVG staff; therefore, in June of 2016, community
leaders and mother guides were invited to share their experiences and lessons learned in a
space where, besides getting to know each other, they would learn about how their colleagues
have overcome barriers to their work in their own communities.
The COMM members gathered to share their workplans and strategies for local activism
in a workshop that took place in the City of Antigua Guatemala the third week of June.
Throughout this process, WVG development facilitators (DFs) shared the findings from a
demographic mapping census, which was the first collaborative project between the MG and
COMM volunteers, in which they gathered demographic data from pregnant women, mothers
of children under 24 months, and children under 24 months.
Additionally, COMM groups presented their short- and medium-term workplans, or
action plans, along with the lessons they’ve learned from working in the committee, seeking
local partnerships, and implementing projects in their unique contexts. The workshop facilitated
groupwork, and volunteers were intentionally assigned to mixed groups with members of other
COMM in order to share their victories and weaknesses together. This exercise eased an open
yet dynamic reflection on lessons from volunteer work, and facilitated the learning process of
addressing different problems encountered in fieldwork.
Towards the end of the workshop, the COMM groups reoriented and strengthened
their workplans, and volunteers from the four ADPs created new working ties with each other.

Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala iv
The mother guides’ face-to-face workshop took place a week after the COMM
workshop; its objectives were the following: to provide a space and structure for MGs to share
their experiences in domiciliary visits, to strengthen the monitoring system, and to stress the
importance of encouraging follow-ups with the beneficiaries of the program. DFs also presented
the results of the demographic mapping exercise, always emphasizing the links between the
census and the recruitment process of MG with pregnant women in their communities.
Towards the end of the workshop, MG reoriented their recruitment strategies;
moreover, the workshop encouraged teamwork and collaboration. Additionally, DFs scheduled
different sessions for formally trainining MG and Leader Mother Guides (LMG) on the adequate
use of monitoring and supervision TTC tools.
This report presents the demographic mapping data, gathered by COMM and TTC
volunteers, as well as the lessons learned from both workshops and the new strategies for each
group’s workplans, a result of the face-to-face exercise.

Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala v
ACRONYMS
ANC Antenatal Controls
ADP Area Development Program
BCC Behavior Change Communication
CBO Community Based Organizations
CHNIS Child Health and Nutrition Impact Study
COCODE Community Development Committee(s) (Comités Comunitarios de Desarrollo)
COMM Community Health Committee(s)
CPI Central Package of Interventions
DF Development Facilitators
DOB Date of Birth
DV Domiciliary Visits
F2F Face to Face
FBO Faith Based Organizations
IGSS Guatemalan Social Security Institute (Instituto Guatemalteco de Seguridad Social)
INCAP Institue of Nutrition for Central America and Panama
(Instituto de Nutrición de Centro América y Panamá)
INFOM Municipal Development Institution (Institución de Fomento Municipal)
LMG Leader Mother Guides
MAGA Ministry of Agriculture
MCH Maternal and Child Health
MG Mother Guide(s) (female volunteer community health volunteer)
NO National Office
PGN National Prosecutor’s Office (Procuradoría General de la Nación)
SWOT Strengths, Weaknesses, Opportunities, and Threats
TTC Timed Targeted Counseling Counseling
WASH Water, Sanitation and Hygiene
WVG World Vision Guatemala
WVI World Vision International

Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala vi
LIST OF TABLES AND FIGURES
CONTENT
Table 1 COMM Action Plans (pre-workshop) ................................................................. 12
Table 2 Lessons Learned from COMM F2F...................................................................... 19
Table 3 MG Observations About Dramatization of Visits............................................ 24
Table 4 Lessons Learned from TTC F2F.......................................................................... 25
Figure 1 Strengths and Weaknesses of Demographic Mapping..................................... 6
Figure 2 Lessons Learned from Demographic Mapping.................................................. 7
Figure 3 Total Pregnant Women per ADP........................................................................ 8
Figure 4 Pregnant Women by Age Groups per ADP...................................................... 8
Figure 5 Pregnant Women Attending ANC in ADP Nuevo Amanecer...................... 9
Figure 6 Pregnant Women Attending ANC in ADP Tinamit......................................... 9
Figure 7 Total Children Under 24 Months per ADP........................................................ 10
ANEXO
Table 5 Key Points Demographic Mapping in ADP Comapa........................................ 28
Table 6 Key Points Demographic Mapping in ADP Tinamit.......................................... 28
Table 7 Key Points Demographic Mapping in ADP Nuevo Amanecer........................ 29
Table 8 Key Points Demographic Mapping in ADP APAS.............................................. 29
Table 9 Pregnant Women by Age Groups per ADP....................................................... 30
Table 10 Pregnant Women by Age Groups & Communities in Comapa..................... 31
Table 11 Pregnant Women by Age Groups & Communities in Tinamit...................... 33
Table 12 Pregnant Women by Age Groups & Communities in N. A............................ 35
Table 13 Pregnant Women by Age Groups & Communities in APAS.......................... 37
Table 14 Pregnant Women Attending ANC in ADP Nuevo Amanecer...................... 39
Table 15 Pregnant Women Attending ANC in ADP Tinamit......................................... 40
Table 16 Children Under 24 Months by ADP..................................................................... 41
Table 17 Children Under 24 Months by Community in ADP Comapa........................ 42
Table 18 Children Under 24 Months by Community in ADP Tinamit......................... 43
Table 19 Children Under 24 months by Community in ADP N. Amanecer.............. 44
Table 20 Children Under 24 Months by Community in ADP APAS............................. 45
Figure 8 Pregnant Women by Age Groups in ADP Comapa......................................... 32
Figure 9 Pregnant Women by Age Groups in ADP Tinamit.......................................... 34
Figure 10 Pregnant Women by Age Groups in ADP Nuevo Amanecer....................... 36
Figure 11 Pregnant Women by Age Groups in ADP APAS............................................. 38
Figure 12 Children Under 24 Months in ADP Comapa.................................................... 42
Figure 13 Children Under 24 Months in ADP Tinamit...................................................... 43
Figure 14 Children Under 24 Months in ADP Nuevo Amanecer.................................. 44
Figure 15 Children Under 24 Months in ADP APAS........................................................ 45

Child Health and Nutrition Impact Study (CHNIS). World Vision Guatemala 2
1. INTRODUCTION
The Child Health and Nutrition Impact Study (CHNIS) is World Vision International’s
(WVI) response to document, through a reseach study, health and nutrition actions focused on
Millennium Development Goals 4 and 5. These goals address the reduction of child mortality in
children under the age of 5, and as well as improved maternal health worldwide. WVI, with the
support of Johns Hopkins University School of Public Health, designed a multicenter study,
which is being implemented in three regions where WVI is present: Cambodia (Asia), Zambia
and Kenya (Africa), and Guatemala (Latin America).
CHNIS is being implemented through three models, all of which are part of a Central
Package of Interventions (PCI). These models address the problems of health and nutrition in
the target population—pregnant women, children under 24 months, and their caretakers, in
three levels. At the individual level is the Timed Targeted Counseling (TTC) model, at the
community level is the Community Health Committees (COMM) model, and at the
environmental level is the Citizen Voice and Action (CVA) model. These three models work
in synergy, supporting mothers and their children and, based on theories of Behavioral Change
Communication (BCC), teach them to overcome the challenges and barriers which families and
communities often face. The implementation of the PCI models was executed in 4 Area
Development Programs (ADP) in the country: 2 in the Central region of Guatemala, and 2 in
the Eastern region of the country.
The Timed Targeted Counseling model (TTC) is based on promoting behavior
change in pregnant women, or families with children under 2, regarding the principles of health
and nutrition. TTC is a method of communication at the household level for BCC that
distinguishes itself from other traditional ways of delivering health and nutrition messages,
because these are delivered according to the needs of the families, not of the educator (i.e.
messages arrive right when the families need them). It is operationalized through 11 domiciliary
visits (DVs) in the period known as the Window of the 1,000 days, with a standardized and
contextualized methodology including the health standards and customs of Guatemala.
Female leaders who have shown altruism for their communities are selected by their
communities to perform the DVs. They are called Mother Guides (MG) because of their selfless
work for the benefit of their community. The MGs are certified in basic health and nutrition
content for the window of 1,000 days in an average period of 24 weeks. The TTC model has
been implemented in Guatemala since 2014.
The Community Health Committee (COMM), a generic title given to a Community
Committee of local partners, coordinate and manage activities aimed at improving community
health and a stronger civil society. A COMM is formed by members of different communities
who represent the different sectors of society, including community leaders, religious leaders,
MGs, educators, representatives of the health sector, and community development leaders such
as the government’s Community Development Councils (COCODES in Spanish). The COMM
also seeks to have a balance of gender and age.

These COMM are trained for one year in health and local advocacy, partnerships, and
collaborative work with local organizations. At the end of their training, they finalize an Action
Plan in which they have, first, identified the main health problems of their community, and
second, broken them down into short-term actions (1 month), and medium-term actions (3
months) to provide a solution. Each action is accompanied by a detailed partnership plan with
local partners and authorities.
With the progress of the implementation of the PCI models in the field, WVG identified
that the MGs and the members of the committees had adopted specific actions to optimize the
processes and functions of the TTC and COMM models, respectively. It was also noted that
there was a wide array of lessons learned that were very valuable to document and share with
other volunteers and the staff of WVG, as well as with members of the Confraternidad, who
are also working with these models in other contexts.
In order to systematize these experiences, the members of the COMM and the MGs of
TTC were invited to share their experiences in an environment that favored the exchange of
knowledge, lessons learned, and action plans in June of 2016. The first face-to-face workshop,
where COMM members shared their experiences, was held on the 22nd
and 23rd
of July in
Antigua, Guatemala, with representatives of 10 community committees who represented the 4
municipalities where CHNIS is carried out.
The second face-to-face workshop, where MGs shared experiences and reviewed the TTC
methodology, occurred on the 29th
and 30th
of June, also in Antigua Guatemala, with the
participation of the MGs and MG leaders (MGL) from the Comapa ADP of the Jutiapa
department and the Nuevo Amanecer ADP of the Guatemala department.
This report presents the exchange of experiences, challenges, lessons learned, and work plans
(or action plans) that were documented in the workshops in Antigua, Guatemala.

2. OBJECTIVES
• To facilitate a face-to-face meeting of volunteers and community leaders in order to
promote an open exchange of experiences, activities, goals, and lessons learned from a
diverse range of participants in the implementation of community health projects in their
own communities.
• To document the activities, projects, obstacles, and lessons learned from community
health committees and mother guides through a thorough, comprehensive, easily
digestible document. This material should be useful for future work plans regarding the
success and sustainability of the COMM and TTC models in the ADPs where the CHNIS
is being measured.
• To document and portray the results of the April 2016 demographic mapping exercise in
a format that is easy to understand and read in order for community health committees,
mother guides, and other WV staff to improve planning, monitoring, and target goal
setting in MCH and nutrition projects in the future.

3. CONTENT AND METHODOLOGY OF COMM
WORKSHOP
The main objective of the COMM workshop was to promote a space for sharing
experiences, work plans, challenges, and lessons learned between the community committee
members of the 4 ADPs in the municipalities where the CHNIS models are located.
During this workshop, aside from sharing their action plans, challenges, solutions, and
lessons learned from field work, the volunteers met each other, understood the context where
they worked, and were able to identify the similarities between the contexts in which they live
and learn the actions that other COMM were taking in regards to the health and nutrition
problems in their communities.
3.1. DEMOGRAPHIC MAPPING
3.1.1 Introduction to Demographic Mapping
One of the most important aspects of the work of both the COMM and the MGs of TTC
is to provide updated information to their communities, specifically the CHNIS target
population: pregnant women, children under 24 months, and their caretakers.
In the absence of recent data from this population, a group of COMM and TTC volunteers
partnered with local health authorities and leaders in April of 2016 and, with the support of
WVG CHNIS development facilitators (DF), organized a demographic mapping exercise. Their
goal was to systematically identify the target population of their work in order to better
understand the status of their communities, have first-hand data, and, based on this information,
refocus actions on health and nutrition.
The mapping information and conclusion presented in this report are based on the data
collected by the members of the community and were presented by the DFs during the workshop. The
data reported are an estimate of the actual values in each community. The process was completed by
volunteers and should not be taken as an official census with the statistical rigor of a similar government
process.

3.1.2 Strengths and Weaknesses of the Process
Among the strengths we can mention: the mapping was carried out by members of the
community, who know the context well, such as the customs and the mobilization of the
different sectors; furthermore, they also presented the work of the committees and MGs in
synergy as part of the Study.
Local health and development authorities also favorably viewed the fact that the same
community will be empowered by this activity and subsequently the information will be shared
with everyone involved.
The most important limitations were that in some sectors, being members of the same
community, some families were not willing to share their personal information, fearing that it
was disclosed or known by others. The information was obtained on a voluntary basis, so this
process does not have strict rigor in its methodology.
Figure 1: Strenghts and Weaknesses of the Demographic Mapping Process
Strengths
•  Coordination and communication
•  Working in pairs and by sectors
•  Meetings with community leaders
•  Digitizing the information
Weaknesses
•  Negativity or lack fo availability
•  Census during regular work hours
•  Fear of giving information/ kidnappings

3.1.3 Lessons Learned
Even though the lessons learned throughout the demographic mapping process vary by
ADP (See Tables 5-8 in Annex 1), there are key conclusions found in many communities.
Figure 2: Lessons Learned from the Demographic Mapping
• Teamwork, coordination, and good communication are crucial: Leaders and DFs
highlighted the importance of working in teams and by sectors as well as of having good
communication and coordination with all stakeholders involved (COMM, MG, health
center staff, and community members). They also spoke about getting organized with
plans, goals, and meetings throughout the process in order to facilitate the data
collection exercise and team efficacy.
• A community’s confidence is very fragile: It is essential to strive for transparency and
good communication with all stakeholders involved, including community leaders. This
not only legitimizes committees, but it also helps them create partnerships, motivates
MGs, involves teenagers and vulnerable, and finally, it strengthens the data collection
process and the sustainability of the committee. Empowering leaders, handing out gifts
or kits for expecting mothers, and bonding with local families also helped the process,
since the community felt as part of the process and felt more comfortable with the
COMM
• The results of the demographic mapping exercise are useful for refocusing
maternal, child and adolescent strategies and projects: The objective of the process
was to identify the MCH needs present in different communities. With the data that has
been gathered, the committees can create new project plans and improve their
workshops for expecting mothers, mothers of young children, and adolescents, ideally
with the support of local medical schools.
Teamwork,
coordination,
and good
communication
are crucial
Mapping
data
inform
COMM,
TTC
Confidence
is very
fragile!

3.1.4 Analysis of Mapping Data for Pregnant Women
TOTALS
The total number of pregnant women counted during the mapping exercise was of 549
women. Volunteers found 121 pregnant women in Comapa and Tinamit each, while there were
89 women in Nuevo Amanecer and 218 in APAS. Volunteers collected the age of the expecting
mothers. See Table 9 in Annex 2 for more details.
Figure 3: Total Number of Pregnant Women by ADP
From the 549 women who were found in the mapping, 467 (85%) reported their age su
and 82 (15%) didn’t. 22% of pregnant women in Comapa, 31% in Nuevo Amanecer, and 22% in
APAS didn’t report their age to the volunteers. However, in Tinamit, 100% of the women
reported their age. The following graph (Figure 4) presents the total number of pregnant
women by age groups (under 19, 19 to 23, 24 to 28, 29 to 33, 34 to 38, over 38 years old, and
age unknown). Tables 10 to 13 and Figures 8 to 11 in Annex 2 convey the number of women found
by age group in each community in the four ADPs.
11
31
22
18
9
3
27
10
45
30
20
16
1 0
6
16
14
11 12
2
28
42
62
39
21 20
7
27
0
10
20
30
40
50
60
<19 19-23 24-28 29-33 34-38 >38 No info
Totalnumberofpregnantwomen
Age groups
Figure 4: Pregnant Women by Age Groups per ADP
(April 2016) n=549
Comapa
Tinamit
Nuevo
Amanecer
APAS
Comapa
121 women
Tinamit
121 women
N.Amanecer
89 women
APAS
218 women
Total: 549 pregnant women

3.1.5 Antenatal Care Attendance
In the ADPs of Tinamit and Nuevo Amanecer, the mapping exercise also asked the
expecting mothers if they assisted antenatal controls and where they did. See Tables 14 and 15
in Annex 3 with information per community in both ADPs.
NUEVO AMANECER
In Nuevo Amanecer, 93.3% of the women (82) reported assisting antenatal care, while
6.7% of women (6) reported not assisting any antenatal care and 1% of women (1) didn’t answer
the question. 48.3% of the women (43) said they attended local health centers, while 4% of
them (4) attended private clinics, 1.1% (1) attended a family clinic, 1.1% (1) attended the IGSS,
23.6% (21) saw a midwife. Moreover, 14.6% of women (13) reported attending more than one
place for their ANC (for example, they attended local clinics and IGSS). See Figure 5.
TINAMIT
In Tinamit, 93.6% of women (117) reported attending ANC, while 6.4% of women (8)
reported not attending any antenatal controls. 91.2% of women (114) attends local health clinics
while 2.4% (3) attends private clinics. See Figure 6.
48%
4%1%
1%
23%
7%
1%
15%
Figure 5:Antenatal Control Attendance of Pregnant Women
(April 2016, n=89)
Local health clinic
Private clinic
Family clinic
IGSS
Midwife
Doesn't attend ANC
91%
3% 6%
Figure 6:Antenatal Control Attendance of Pregnant Women
(April 2016) n=124
Local health cinic
Private clinic
Doesn't assist ANC

3.1.6 Analysis of Mapping Data for Children Under 24 Mo.
TOTALS
The total number of children under 24 months counted during the mapping exercise was
of 1,468. Volunteers found 246 children in Comapa, 369 in Tinamit, 246 in Nuevo Amanecer,
and 607 in APAS. See Tables 6 to 20 and Figures 12 to 15 in Annex 4 for information disaggregated
by community.
Figure 7: Total Children Under 24 months by ADP
Tables 10 and 13 in Annex 3 show the data collected disaggregated by community, age, and
sex. Volunteers were able to gather the age of all children under 2 years in Comapa, Tinamit,
and Nuevo Amanecer, and only missed the age of 10 children in APAS. See Figure 8.
67 62 64
53
0
92
112
66
99
0
66
60 65
55
0
137 142
150
168
10
0
20
40
60
80
100
120
140
160
180
0-12 F 0-12 M 13-24 F 13-24 M No Info
TotalNumberofChildren
Age (months) and Sex
Figure 8: Children Under 24 Months by ADP (April 2016) n=1468
Comapa
Tinamit
Nuevo Amanecer
APAS
Comapa
246 children
Tinamit
369 children
N.Amanecer
246 children
APAS
607 children
Total: 1468 children under 24 months

3.2 COMM ACTION PLANS
3.2.1 Introduction to COMM Action Plans
The Action Plan is the last step finalized by the members of a COMM, once they have
identified the following components:
• Prioritization of health problems in their communities
• Principal local actors who can support solving the problems
• Level of community involvement at different stages
• Short term goals (1 month) and medium term (3 months)
The Action Plans are embodied in a simple format (the problem and solution) and must
be presented to the community in a session with the support of local health authorities.
The following table (Table 1, 3.2.2) is an agglomeration of all of the action plans
presented at the workshop. The names of the communities and COMMs, organized by ADP
(Comapa, Tinamit, Nuevo Amanecer, and APAS), can be found on the top rows (in Light
Yellow). The first two columns on the left hand side outline the themes or categories presented
by the committees. These are the following: General COMM (information about the structure
of the committee, in Blue), Partnerships (in Orange), Activities (interventions classified by
theme, in Dark Orange), Challenges and Solutions (classified by theme, in Green), and finally,
Conclusions and Next Steps (in Red).
This last category (Challenges and Next Steps) is conformed by two parts. The first part
(p.13, Lessons Learned From Their Work Thus Far (pre-workshop) shows the key elssons and
conclusions the presenters mentioned as part of their work so far (how have they changed their
implementation, communication, and collaboration strategies thus far?). The second part (p.14,
Changes to Action Plans Based on Lessons Learned During the Workshop), shows the new
changes each committee individually reported they were committed to after participating in the
workshop. This section of the workshop is based on two sources of information: first, on the
final presentations of each committee on the second day of work; second, on the updated
COMM action plans that the DFs sent the NO staff the following week.

3.2.2 COMM Action Plans
Table 1: COMM Action Plans (pre-workshop)
ADP APAS Tinamit Junam N.Amanecer Comapa
General
COMM/
communities
Nuevo
Amanecer,
Quebrada Seca
Vida y
Esperanza: Las
Pilas, La Ceibita
Salud y Vida:
Cohetero
Salvamos Vidas.
Pipeltepeque
Abajo
San Jerónimo Nueva
Esperanza,
Estancia
Grande
San Raymundo,
Estancia vieja
San Francisco,
Comalito,
Tepenance,
Carrizo
About
COMM
30!12
members
1,964 people
Divided by
sectors and
use SWOT.
5,600 people
20!11, only
women. No
board. 2,100
people.
16!13 people.
Board and
committees by sector
1,478 people
President
left group
Divided by
sectors
12 members
(3 per
community)
Partnerships
Relationship
con
COCODE
Links and
collaboration.
Members on
both
committees.
Local
COCODE had
financial
interests, so
COMM didn’t
partner with
them.
Links. One
member in
COCODE but
they are
lacking
support
Good
communication to
identify needs: “We
handle COCODE”.
Shared members.
COCODE
wouldn’t support
them until they
insisted
Coordination
against chagas
diseases
Government MAGA has
provided aid;
govt helps
with disease
control
Partnerships:
help with kits
for pregnant
women
Local health
centers
support
them against
malaria
Local health
centers
support them
Partnership
with PGN y
health clinics
Government
supported
“charlas” but not
enough
Coordination
with
municipality
Churches Hands out food
to people with
disabilities
Links with
Catholic
Church
Schools Links with
volunteers
Good
communication
and links
F. Marroquin
Academy helped with
census and extra
workshops
Links for
zika and
cleaning
Parents, teachers,
and students
collaborate
Others Partnership
with
Fundabien
Collaborates
with youth
group
Partnership with
Novella Foundation +
cement donations
Coordinatio
n with media
WV Taiwan
sends money
to fight chagas

Activities
Cleaning/
Waste
management
Cleaning
water pilas,
eliminate
mosquitos
Waste
management,
cleaning roads
Cleaning to
avoid
mosquito
breeding
Waste
management
and cleaning
Community
cleaning
Waste
management;
reforestation
Recycling
“Charlas” or
educational
talks to the
community
Charlas on
mosquitoes
and diseases
7-11 strategic
trainings
President
participates
in
workshops
Charlas for
families to
encourage
behavior
changes
Community
mobilization to raise
awareness of
common health
problems
Charlas in
local mayan
languages
Charlas on
nutrition and
MCH
WASH and
Nutrition
Distribution of
food packages
(“víveres”)
Partnershihps
for latrine
projects
Chlorine to
clean water
COCODE and govt
helped to expel farm
causing diseases and
malnutrition
Project to clean
water system
“Revocos”
(plastering) to
prevent
chagas; wells.
MCH Talks for
pregnant
women and
mothers
(w/gifts + kits
and nets);
Census.
Census,
strategic 7-11
training,
mosquito nets.
Counseling
to pregnant
women (kits
and nets).
Work on
child
malnutrition
Capacitación y
censo
Visits to pregnant
women with kits and
nets. MCH charlas
and pap smear.
Raising funds for
pregnant women +
emergencies
Identify and
train
pregnant
women.
Club of
expecting
mothers.
Charlas for
pregnant women
and mothers.
Immunization
days.
Census.
Vulnerable
populations
Visits and
identification
of children
with special
needs or low
weight
House visits to
people with
special needs.
House visits
and
distribution
of food
packages to
people with
special needs
House visits
and food
packages for
people with
special
needs—with
funds raised
by COMM.
Census (before the
WV-led one).
COMM supports the
elderly. Received
donations
(wheelchairs,
surgeries) by
reaching out to other
orgs.
House visits
to people
with special
needs
Disease
control
COMM
demanded
govt help with
malaria
prevention
Zika prevention;
support local
health center on
deworming
Govt
support w/
malaria. Zika
talks
Zika talks.
Vaccinations
against
tetanus
Zika talks.
Fumigation.
Chagas
prevention:
plastering,
talks

ChallengesandSolutions
Distances
and violence
COMM
travels every
15 days, visit
per sectors
because of
distances
In January, they
started a
campaign against
violence
Fear of being
assaulted or
mugged.
Both
violence and
distances are
major
challenges.
Insecurity and
violence are
increasingly difficult
challenges to deal
with.
Access to
local health
services
Good
communicatio
n. They gave
them chlorine
bags.
Co-created
proposal for
latrine project.
Culture,
education,
context (e.g.
machismo,
history of
failed
projects)
Challenges of
motivation
and retention
of committee
members.
Initial mistrust
and lack of
community
support—now
they
congratulate
COMM and
participate in
activities.
Child
malnutrition
common and
mothers
don’t take
children to
clinic
because of
public
opinion and
mockery.
Leader looks for gifts
to motivate and
involve community
members. Through
partnerships, they
kicked out local farm
that was
contaminating food
and water sources.
Language
and
education
barriers are
challenges to
project
proposals
and
community
mobilization
Recursos:
recaudación
de fondos y
propuestas
Petty cash for
emergencies,
Q2.00 per
reunion,
raffles and
junk sales.
De chatarra.
Poverty and lack
of education are
major barriers
to project
proposals.
SWOT
Analysis.
COMM
raises funds
through
raffles and
sales of used
clothes—for
emergencies
and goods
for people
with needs.
No petty cash,
they are
looking for
better
strategies for
raising funds.
Use of record book;
sales for fundraising;
project profile for
partners to learn
about community.
Fundraising for
emergencies.
Importance of
monitoring and
transparency of
activities and funds.
Taiwan WV
sponsors
many of
Comapa
projects

ConclusionsandNextSteps
Key Lessons
of their
Work Thus
Far (pre-
workshop)
Working in
small groups
and by sectors
is more
efficient.
Partnerships
with
foundations
and good
communicatio
n with the
government
help get work
done and be
recognized.
COMM takes
photos for
evidence.
Good
communication
with local health
center and
schools
improves
COMM results.
Community
mobilization is
important for
community
waste
management
projects.
The
community
is thankful
for COMM’s
work.
COMM’s
goal is
sustainability
and
structure.
COMM
takes photos
for evidence
of their
activities.
COMM
should
identify most
common
diseases in
their
communities
Using
SWOT
Analysis
helps
evaluate
analylsis and
improves
confidence
of
community.
COMM
establishes
goals with
percentages
and numbers.
Coordination
with partners
is key.
Conducting a census
by stages (people
with special needs,
elderly, pregnant
women, adolescents,
children) is useful for
efficiency and order.
Good
communication and
information sharing
helps manage
partnerships.
Transparency and
monitoring are very
important. This
community will have
proper norms and
laws.
Partnerships
are crucial
to achieve
objectives.
Activities by
sectors can
improve
results.
COMM
needs to
improve its
leadership.
This COMM
started a
project for a
Community
Meeting
Room with
COCODE
and
municipality
of San Juan
Sacatepéque
z
COMM insisted
on asking
COCODE for
help and
accompaniment.
They work by
sectors and have
immunization
days.
COMM uses
photos for
evidence. It
was useful for
COMM to
focus on the
prevention
and financing
of one disease.

Changes to
Action Plans
Based on
Lessons
Learned
During the
Workshop
- Continue
cleaning
mosquito
breeding
sites (every
3 months)
- Start
workshops
and talks on
waste
management
- Strengthen
fundraising
mechanisms:
monthly
quotas, junk
sale (every 3
months)
- Manage
workshops
in schools
- Verification
and cleaning
of wells
- 3 visits to
institutions
(coordination
with INFOM,
municipality,
COCODE) to
follow-up
latrine
project,
manage
projects to
prevent infant
deaths, lead
projects of
community
mobilization
and
community
empowermen
tgestionar
proyectos de
movilización/
empoderamie
nto.
- Cleaning and
waste
management
- Chagas
prevention
with local
health center.
- Continue
partnership
with schools,
churches, etc.
- Capacitación
salud sexual
- Continue
community
cleaning and
waste
management
- Partnerships
with
schools,
NGOs,
government.
- Self-
financing
mechanisms
- Ask
municipalitie
s trees
donations
for
reforesting
campaign
- Continue
cleaning
mosquito
sites
- Charlas for
families on
the environ-
ment,
recycling,
hygiene
- Get organized
to obtain
funds (quotas
on reunions)
- Work for
pregnant
women,
children,
people with
special needs
- Improve
house visits
The execution of the
projects is achieved
through teamwork
and partnerships.
COMM
learned the
importance
Aprendieron
importancia
de organizar,
involucrar a
COCODES
y a
comunidad,
buscar
asocios.
- New project
to clean
water
- Continue
cleaning
streets
- Minimize
mosquito
breeding sites
to prevent
disesaes

3.2.3 Conclusions from Action Plans
The COMM groups have achieved important victories in their communities. Even
though the volunteers only dedicate their free time to the work of the committee, they
work on a wide variety of issues and projects.
COMM groups have created partnerships and aliances with COCODE groups,
local health centers, churches, schools, foundations and other organizations working on
community development, MCH, disease control, and more.
Even though the context and conditions of each community are different, their
activities can be classified in the following categories: cleaning and waste management,
charlas or community health talks, WASH and nutrition, MCH, vulnerable populations,
and disease control. The main challenges of COMM groups can be classified in the
following categories: distances and violence, access to health services, culture and
context, and fundraising and grant proposals.
Throughout their work, community leaders have learned a tremendous amount
on how to get organized and work efficiently. Among the lessons learned from their
work so far, committees have learned about the importance of teamwork, good
communication, collaboration with partners, creation of confidence bonds with
communities, evaluation and monitoring of their projects, and community mobilization
for ensuring sustainability.
The new activities and strategy changes that the COMM are planning to
implement show resiliency, creativity, and motivation to improve their communities.

3.3 LESSONS LEARNED FROM THE FACE-TO-
FACE COMM WORKSHOP
3.3.1 Introduction to Lessons Learned
This section presents the participants’ lessons learned. The second day of the
workshop, participants were randomly assigned to groups to discuss lessons learned
during the workshop. Therefore, the content of this section is based on the
presentations of these random groups of COMM leaders; the structure of this section
follows that of the action plans above (section 3.2).
The first two columns of the left side of the table reflect the same categories of
the above action plans: COMM General (motivation and values, structure, operations,
sustainability, and voice, in Blue); Partnerships (with COCODE, government, schools,
churches, and other organizations, in Orange); Activities (classified as above, in Yellow);
and finally, Challenges and Solutions (classified by topic, in Green).
Given that this exercise took place with mixed groups, the following table (Table
2) doesn’t have the results presented by COMM, community, or ADP; however, this
includes information from all the participants present. For each theme in the first two
columns, this table explores the lessons learned from the workshop (what did we learn
and how is that important?), and examples of actions and activities for the next few
months (how will the COMM groups change their strategies?).

3.3.2 ¿What Did We Learn and How Will We
Improve?
Table 2 Lessons Learned from COMM F2F Workshop (June 2016)
Topic
What did we learn and why is
it important?
Lessons learned
How will the COMM change?
Examples of new actions or activities
COMM
Motivation
and values
Motivation and recognition
of COMM members is
important to continue
working and accomplish
changes in the community’s
health. En la comunidad.
• Create partnerships to learn from others
• Persevere, be responsible, lead by example
• Have initiative
• Become leaders to serve others
• Work in teams and motivate the team
• Be optimistic in decision making processes
Structure Inclusion of different sectors
and groups legitimizes the
committee and its activities.
• Have agendas of leaders by sectors
• Delegate responsibilities
• Discuss how to organize the committee
(executive board vs no board, transparency,
division of responsibilities, etc.)
• SWOT Analysis (Strengths, Weaknesses,
Opportunities, Threats)
• Diversify COMM: include children, youth,
elderly, women, people in other orgs
• Work in pairs
Operations Managing work with goals and
objectives legitimizes and
organizes the COMM’s
interventions.
• Management and transparency of activities
and finances
• Update workshops and charlas
• Coordinate work schedules among
members of committee and community
• Insist on problem-solving and conflict
resolution mechanisms within group y
transparencia de proyectos: actividades y
financiamiento
Sustainability It’s important to raise
awareness about the
temporary role of WVG
versus the permanent role
of COMM.
• Dedicate more time to meetings and
workshops—be available to help solve
community’s problems
• Don’t give up
Reconoci-
miento y voz
It’s important to organize the
committee with
rofessionalism in order to
earn the community’s
confidence and protect the
COMM’s image.
• Turn criticism into positive actions
• Earn people’s trust
• Solve misunderstandings
• Ignore gossip in order to improve leadership
• Identify altruistic community members who
might want to join the COMM.
• Demonstrate WV’s accomplishments are for
the community’s wellbeing.

Partnerships
Relationship
with
COCODE
Improving relationship with
COCODE can help COMM
obtain legal and social
recognition.
COCODE are the
maximum authority
(ideally) elected in the
communities. Their support is
essential to our work.
• Collaborating with local government is key
to formalize project proposals and have
more support.
• Explaining our work and partnership
proposals to COCODE.
• Follow-up to conflict resolution mechanisms
to avoid future programs and facilitate
collaboration on activities and projects.
Government
(health and
nutrition
sector)
Collaboration with health
centers is important to
maximize the resources,
personnel and supplies they
have, for disease control and
preention, workshops and
trainings, MCH, and more.
They have the mandate and
state authority to provide
healthcare to the population.
• Create links and partnerships with local
health centers; ask them for help when
organizing workshops and charlas
• Demand resources to combat community
health problems (example: chlorine bags to
clean water, nurses for ANC, sex ed talks
for teenagers)
Schools We must take advantage of
the knowledge and abilities
of the students, teachers and
parents of local schools. Their
help can be useful in health
and hygiene campaigns,
program improvement,
leadership development, and
more.
• Coordinate with medical students and
teachers to bring workshops and charlas to
family members, leaders, and broader
community.
• Coordinate with schools in order to
collaborate with graduating students: create
links and opportunities for them to do their
practicum or senior projects on community
health.
Churches Links with churches can help
COMM activities: they have
resources and programs for
child development and
community wellbeing, as well
as links to the community.
• Ask churches for help with fundraising
efforts and identification of pregnant women
and vulnerable populations.
• Create partnerships with faith-based
organiations (FBO) through good
collaboration and common values.
Others COMM should focus on
collaboration with institutions
that work locally or are
interested in donating
supplies or other resources to
help with project
development, fundraising,
partnerships, future
opportunities, and wider
recognition. Together, we
can do more.
• Collaborate with and help MGs
• Create proposal for Novela Foundation
(example), as long as the project proposal is
focused on community health and nutrition.
• Ask WV to organize workshops and
trainings on grant writing and project
proposal.
• Look for companies and private sector
organizations that may donate supplies or
funds.
• Take into consideration all existing
community based organizations (CBOs) to
create partnerships and strengthen
relationships.

Cleaning and
waste
management
COMM has an important role
maintaining the community
clean in order to be seen on a
positive light as well as to
prevent diseases.
• Follow-up cleaning and waste management
projects (including cleaning mosquito
breeding sites)
• Promote cleanliness inside and outside
homes and in public spaces
• Ask the municipality for trees in order to
organize reforestation campaigns
• Organize talks/charlas on waste
management through meetings in schools
and in coordination with CBOs; promove
behavior change communication (BCC) on
waste management
Activities
Talks
(charlas) and
workshops
It isns’t enough for COMM
members to implement
activities alone. COMM must
serve, mobilize, and
educate others to create a
widespread change in
community health initiatives.
• Include community members in the planning
and implementation of health interventions
• Improve leadership training before they give
workshops to the rest of the community
• Put in practice and share lessons learned in
COMM workshops and trainings
WASH and
Nutrition
Water affects everyone’s
health in a community,
particularly that of vulnerable
populations like children and
the elderly. Improved
sanitation conditions,
latrines, and better nutrition
are essential to the wellbeing
and growth of children.
• Organize campaigns for water chlorination
• Promote the creation of more classrooms
to improve learning conditions for children
• Verify the cleanliness and conditions of wells
and tanks with drinking water
• Follow up latrine requests with local
government
• Organize and manage food supplies for
people in need
MCH The committee is responsible
for identifying and
minimizing risks of mothers
and children.
• Know how to identify and educate about
warning signs in pregnancies and infants
• Pay attention to and prioritize pregnant
women and children
• Collaborate with and help support MGs
• Improve house visits
Vulnerable
populations
The committee is responsible
for prioritizing vulnerable
populations.
• Work by sector
• Pay attention to and work in solidarity with
vulnerable populations (pregnant women,
people who are sick or have special needs,
etc.)
• Include everyone in the committee and its
activities
• Visit people with special needs
Disease
control and
prevention
Infectious diseases affect
everyone’s health,
especially that of vulnerable
populations and children.
• Coordinate with nurses for health talks on
malaria and other diseases
• Train mothers to identify symptoms of
common diseases
• Improve charlas on infectious diseases

ChallengesandStrategies
Distances
and violence
Violence, and insecurity are
obstacles for volunteers.
• Organize campaigns against violence
• Include youth in activities and COMM
leadership
Access to
health
services
Distances and limited
transportation are obstacles
for volunteers. COMM must
look for better access to
health centers for their
comumunities
• Manage proposals of health centers in
communities where there are no clinics
Culture,
education,
context
(machismo,
history)
A key factor for COMM
groups is community
participation and the
establishment of needs and
goals of the local
socioeconomic, religious,
political, and cultural context.
COMM must respect and
include this context in
project proposals, particularly
when creating aliances with
CBOs and FBOs.
• COMM must establish needs and
community expecatations (through good
communication and inclusion)
• COMM must tell external trainers or
educators (nurses, students, etc.) the
material and context they would like them
to cover in their talks (for example,
abstinence instead of safe sex education)
Resources:
fundraising
and project
proposals
Fundraising facilitates and
improves the committee’s
activities, especially funds used
for emergencies or to help
people with special needs.
• Organize raffles, food or clothe sales, junk
sales, fundraising campaigns, committee
quotas, etc.
• Save funds
• Write project proposals to foundations or
other NGOs; formalize them with COCOE
support, signatures, and seals.
3.3.3 Conclusions
COMM leaders are motivated to continue working for the improvement of their
communities. The workshop allowed them to reflect on the different components of
their work as well as to share experiences with each other, refocus their strategies, and
adopt different projects from other committees.
3.4 FOCUS GROUP
Even though the NO CHNIS staff had not planned to conduct a focus group as
part of the workshop agenda, they took advantage of the opportunity to gather ten
COMM leaders (representing all the communities that attended the workshop) in a
room to share experiences with each other. Participants were asked questions about
WVG’s performance, local partnerships, and sustainability. The details and results of this
focus group are presented in the report Case Study: Focus Group of COMM Leaders

4. TTC WORKSHOP: CONTENT &
METHODOLOGY
The Timed Targeted Counseling (TTC) promotes behavior change on topics of
health and nutrition in pregnant women and/or families with children under 2. TTC is a
methodology for BCC at the family level. TTC is unique because the health and
nutrition messages it gives the families are given at the right moment—when families
need them.
The focus of the TTC workshop was different to that of the COMM one, as
besides sharing experiences, MGs also reviewed TTC methodology and concepts from
their training, like DVs and monitoring and supervision tools. This section of the report
reviews the activities of the workshop as well as the lessons learned from the event.
4.1 OVERVIEW OF ACTIVITIES
The workshop reviewed three areas of knowledge the MG should know for
volunteering as part of TTC: general knowledge on TTC methodology, content of house
visits, results of the demographic mapping, and the use of monitoring and supervision
tools.
4.1.1 Demographic Mapping
Similarly to the COMM workshop, the TTC workshop also included a
presentation on the demographic mapping conducted by COMM and TTC volunteers
and local community leaders (see section 3.2 Demographic Mapping). This session was
very important since the MGs played a crucial role in the data collection process. The
need to share the results of the mapping with them was important since they were to
include all pregnant women and children under 2 in their target population. Additionally,
MGs became familiar with other sectors of their communities and worked alongside
volunteers from COMM.
4.1.2 Monitoring and Supervision Tools
During the workshop, participants were reminded of the importance of filling
out monitoring and supervision tools for MGs and LMGs, the frequency with which to
fill these out, and the meetings in which they are to turn these forms into their
supervisors (every three months). The LMGs were handed a folder with fifty copies of
each monitoring and supervision form (nine in total). Similarly, the DFs are responsible
for training MGs on how to fill out forms for pregnant women, mothers, and young
children.

4.1.3 Overview of TTC Basics
The participants of the workshop were MG and LMG. In order to review the
material of the TTC methodology, the CHNIS NO staff organized a game, “100 Mother
Guides Said” (based on a Mexican TV show) between two different teams of randomly
assigned participants. The MG and LMG reviwed the methodology of TTC, including
details about home visits and the counseling process for pregnant women and their
families.
WV personnel also acted out a negative and a positive house visit while the
participants identified positive and negative attitudes from the dramatizations. The
following table (Table 3) conveys the results of this exercise.
Table 3: Observations from MG on House Visit Dramatizations
Negative Attitudes Positive Attitudes
• Partner refuses visit
• MG with condescending attitude
• MG didn’t ask for permission to sit
• Incorrect counseling
• Bad influence from other family members
• “Don’t go to the health center”
• Poor use of visit supplies
• MG changed the history on booklet
• MG without preparation
• MG forgot tools
• Gossip and interruption
• MG didn’t follow order of steps
• MG didn’t sit in front of the family
• MG didn’t finish counseling
• Not paying attention
• Visit isn’t opportune
• Forgets important points of visit 5
• MG leaves booklet at home
• MG didn’t mention previous sessions
• Ignoring a partner
• Incorrect hand-washing technique
• Poorly kept negotiation tool
• Poorly kept counseling booklet
• Not scheduling an exact visit.
• Calling her supervisor by phone to get
information from
• Greeting the family respectfully
• Calling the husband or partner to be
part of the visit
• Opportune visit
• Follow up on counseling
• Newborn screening delicately
• Takes into consideration problems
reported by the family
• Good use of the tools and booklet
• Family invites MG to take a seat
• MG involves the family
• Eye contact
• Family grants MG time for visit
• Good use and position of the visit
materials

4.2 LESSONS LEARNED AND NEW STRATEGIES
FOR TTC
4.2.1 Introduction to Lessons Learned
This section presents the lessons learned throughout this face-to-face workshop
for GM and LGM. The second day of the workshop, participants were randomly
grouped to reflect on the material that was reviewed through the different workshop
activities. Therefore, this section outlines content presented by the workshop
participants themselves.
4.2.2 What Did We Learn and How Will We
Improve?
Table 4 Lessons Learned from TTC F2F Workshop (June 2016)
When?
Why is this Important?
Lessons Learned
New Strategies and
Examples of Activities
Preparing
for house
visits
For the methodology of TTC, it is crucial that
domiciliary visits are done in a timely manner,
therefore counseling with the correct advice at
the proper stage of a pregnancy or of a child’s
development.
Prepare adequately for
visits in order to know and
understand the content of
each of their visits.
Visit number 5 is the most important one,
since it is done duringthe first week of an infant’s
life.
Be familiarized with the
material of visit 5 and the
danger signs for both
pregnant women and
infnats.
GM are responsible for knowing which
families depend on their counsel, this includes
keeping track the pregnancy stages of each
woman and the ages of children.
Write down DOB and
dates of expected delivery
to follow-up appropriately.
During the
visits
It is important to include other members of
the family in the visit and encourage them to
support women in the BCC processes for
better health and nutrition.
Motivate other family
members to participate in
the visit and activities.
Breastfeeding is the best option for an infant’s
nutrition and growth in the first six months of
life.
Motivate and promote
mothers to give exclusive
breastfeeding to their
babies.
4.2.3 Conclusions
Even though MGs and LMGs have been extensively trained on TTC
methodology, DFs must continue to monitor and supervise volunteers during
domiciliary visits to ensure the model is implemented adequately.

5. CONCLUSIONS AND RECOMMENDATIONS
The members of COMM and the MGs that support the TTC model have been able
to mobilize and raise awareness among their communities, communicate and collaborate
with the government and other community development organizations, promote
behavior change in topics of health, nutrition, waste management, disease prevention,
and more.
The face-to-face workshops were a unique opportunity for the community leaders
to meet, present their successes and challenges, learn from their colleagues, and
recognize their own work and that of other volunteers.
WVG has the responsibility to follow up on the agreements and capacity building of
volunteers from both COMM and TTC models, and to continue to accompany them in
their field work in order to continue with their selfless volunteer work in the benefit of
their communities.

ANNEXES
1. LESSONS LEARNED FROM DEMOGRAPHIC MAPPING 28
1A. COMAPA 28
1B. TINAMIT 28
1C. NUEVO AMANECER 29
1D. APAS 29
2. PREGNANT WOMEN BY AGE GROUPS 30
2A. TOTALS 30
2B. COMAPA 31
2C. TINAMIT 33
2D. NUEVO AMANECER 35
2E. APAS 37
3. ANC ATTENDANCE BY PREGNANT WOMEN 39
3A. NUEVO AMANECER 39
3B. TINAMIT 40
4. CHILDREN UNDER 24 MONTHS BY ADP 41
4A. TOTALS 41
4B. COMAPA 42
4C. TINAMIT 43
4D. NUEVO AMANECER 44
4E. APAS 45

ANNEX 1: LESSONS LEARNED FROM DEMOGRAPHIC
MAPPING BY ADP
ANNEX 1A. COMAPA
Table 5 conveys the strengths, weaknesses, and lessons learned during the
demographic mapping process in the ADP of Comapa
ANNEX 1B. TINAMIT
demographic mapping process in the ADP of Tinamit
Talbe 6 Key Points of Demographic Mapping in Tinamit
Strengths Weaknesses Lessons Learned
• Coordination with nurses
• Meetings before the census
• Coordination with
community leaders
• Support from local health
centers
• Scheduling census
activities during work
hours
• Fear to disclose
information
(“history”)—however,
families show interest
after understanding the
Study’s purpose
• Some women are afraid
to disclose their
pregnancy
1. In Estancia Rosario, mothers feel
supported by volunteers
2. Families are thankful for COMM
work
3. Handing out mosquito nets or
pregnancy kits is helpful for getting
people to participate in census
4. Fear of children kidnappers is
present in many communities and is
a barrier in data collection
5. In some families, the partner’s
authorization or approval for
disclosing information is a problem
(machismo)
6. Average age of pregnant women is
25
Table 5: Key Points of Demographic Mapping in Comapa
• Volunteers work on
mapping in communities
they are familiar with
• Division of labor
• Organize meetings in order
to inform the community
about the census exercise
• Scheduling census
activities during work
hours
• Fear to disclose
information
(“history”)—however,
families show interest
after understanding the
Study’s purpose
• Some women are afraid
to disclose their
pregnancy
1. Coordination and leadership
empowerment
2. COMM recognizes importance of
census
3. Dedication and love for their
community
4. Strategies used in census (example:
mosquito nets, pregnancy kits)
5. Meetings and community gatherings
6. Respect other’s work hours
7. It’s important to inform
communities on the use of data,
since they’ve been lied to with other
projects in the past
8. Earning a community’s confidence is
a delicate process!

ANNEX 1C. NUEVO AMANECER
demographic mapping process in the ADP of Nuevo Amanecer
ANNEX 1D. APAS
demographic mapping process in the ADP of APAS
Talbe 7 Key Points of Demographic Mapping in Nuevo Amanecer
Lessons Learned
1. GM work alongside COMM and learn about each other’s work.
2. Getting to know families
3. Community leaders support COM and GM in data collection processes
4. Teamwork matters
5. Planning and organizing activities and gatherings helps data collection and team efficacy
Talbe 8 Key Points of Demographic Mapping in APAS
• WV DFs already had
access to some
information that
census was collecting
• Seeking support of
partners and health
centers
• Work in pairs and by
sectors can be more
efficient than alone
• Some volunteers
dedicated a full day’s
worth to collect data
• Data digitalization
• Lack of time
• Negativity
(particularly in
new COMMs who
were expecting
personal benefits
from helping with
census)
1. Teamwork matters
2. Good communication is
key
3. Divide groups by sectors
4. Coordinate with local
partners
5. COMM members are
recognized for their work
6. There are pregnant girls
who are 13 or 14 years
old!

ANNEX 2: PREGNANT WOMEN BY AGE GROUPS
ANNEX 2A. TOTALS
Table 9 Pregnant Women by Age Groups and ADP (April 2016)
Age (years)
Average
age
Total*
average
age
Min age Max age
ADP
<19 19-23 24-28 29-33 34-38 >38
No
info
Women
w/ age
info
Comapa 11 31 22 18 9 3 27 94 25.5 2400 0 45
Tinamit 10 45 30 20 16 1 0 122 25.7 3135 16 38
Nuevo
Amanecer 6 16 14 11 12 2 28 61 26.8 1636 16 43
APAS 42 62 39 21 20 7 27 191 24.4 4659 13 43
TOTAL 69 154 105 70 57 13 82 468 11830 0 45
15% 85%
Average
age 25.3

ANNEX 2B. COMAPA:
In the ADP of Comapa, volunteers found a total of 121 prengnat women, 22% of which (27 women) didn’t report their age. From
the 94 women who did report their age, average age was 25.5 years old, the youngest woman was 15 years old and the oldes
woman was 45 years old. See Table 10 and Figure 8.
Table 10 Pregnant Women by Age Groups and Communities in ADP Comapa (April 2016)
Community
Total
Age (years)
Women
w/ age
info
Average
age
Total*
average
age
Min
age
Max
age
<19 19-23 24-28 29-33 34-38 >38
No
Info
Chinchintor 19 0 6 5 3 4 1 0 19 28 536 19 43
San José 21 3 6 5 2 3 1 1 20 26 513 17 45
San Juan 14 1 6 2 4 0 1 0 14 26 360 18 43
Calvario 4 4 0
Guayabo 7 0 4 2 0 1 0 0 7 24 171 20 36
Cerrito 7 7 0
Carrizo 23 4 6 4 6 0 0 3 20 24 475 15 32
San Francisco 8 1 2 0 2 1 0 2 6 26 155 17 35
Comalito 14 2 0 4 1 0 0 7 7 24 171 18 33
Tepenance 4 0 1 0 0 0 0 3 1 19 19 19 19
TOTAL 121 11 31 22 18 9 3 27 94 2400 15 45
22% 78% 25.5
Average
age

9%
26%
18%
15%
7%
3%
22%
Figure 8 Pregnant Women by Age Groups in ADP
Comapa (April 2016) n=121
<19
19-23
24-28
29-33
34-38
>38
No info

ANNEX 2C. TINAMIT:
In the ADP of Tinamit, volunteers found a total of 121 pregnant women, 100% of which reported their age. The average age
was 25.7 years old, the youngest woman was 16 years old and the oldes woman was 39 years old. See Table 10 and Figure 8.
Cuadro 11 Pregnant Women by Age Groups and Communities in ADP Tinamit (abril 2016)
Community
Total
Age (years) Wome
n w/
age info
Average
age
Total*
promedio
edad
Edad
más
baja
Edad
más
alta<19 19-23 24-28 29-33 34-38 >38
No
Info
Estancia Rosario 24 0 8 9 6 1 0 0 24 26 623 19 34
Estancia Grande 35 4 13 8 4 6 0 0 35 26 893 16 38
San Jeronimo 33 6 12 5 8 2 0 0 33 24 804 16 37
Guates 29 0 12 7 2 7 1 0 29 27 790 19 39
TOTAL 121 10 45 29 20 16 1 0 121 3110 16 39
0% 100% 25.7
Average
age

8%
37%
25%
16%
13%
1%
Tinamit (April 2016) n=121
<19
19-23
24-28
29-33
34-38
>38
No info

ANNEX 2D. NUEVO AMANECER:
In the ADP of Nuevo Amanecer, volunteers found a total of 89 pregnant women, 31% of which (28 women) didn’t report
their age. From the 68 women who did report their age, the average age was 26.8 years old, the youngest woman was 16 years old
and the oldes woman was 43 years old. See Table 12 and Figure 10.
Table 12 Pregnant Women by Age Groups and Communities in ADP Nuevo Amanecer (April 2016)
Community
Total
Age (years) Women
w/ age
info
Average
age
Total*
average
age
Min
age
Max
age
<19
19-
23
24-
28
29-
33
34-
38 >38
No
Info
Llano de la Virgen 14 1 3 1 1 2 1 5 9 27 245 17 41
Pamoca 24 3 1 5 1 1 0 13 11 24 261 16 35
Cipres/ Parcelas 16 0 3 2 4 4 1 2 14 30 416 19 43
El Carrizal 3 0 0 0 0 1 0 2 1 35 35 35 35
Estancia Vieja 10 1 2 3 1 2 0 1 9 27 242 18 35
San Martinero 22 1 7 3 4 2 0 5 17 26 437 16 38
TOTAL 89 6 16 14 11 12 2 28 61 1636 16 43
31% 69% 26.8
Average
age

7%
18%
16%
12%
14%
2%
31%
Nuevo Amanecer (April 2016) n=89
<19
19-23
24-28
29-33
34-38
>38
No info

ANNEX 2E. APAS
In the ADP of APAS, volunteers found a total of 218 pregnant women, 12% of which (27 women) didn’t report their age. From the
68 women who did report it, the average age was 24.4 years old, the youngest age was 13 and the oldest 43. See Table 13 and
Figure 11.
Cuadro 13 Pregnant Women by Age Groups and Community in ADP APAS (April 2016)
Community Total
Age (months)
No
info
Wome
n w/
age info
Average
age
Total*
average
age
Min
age
Max
age
<19 19-23 24-28 29-33 34-38 >38
Cerro G.Barreal 2 0 1 0 0 0 1 0 2 32 64 23 41
Cerro G. N. Esperanza 9 2 4 1 0 1 1 0 9 25 224 16 39
Pilas 15 3 2 6 2 2 0 0 15 25 379 17 17
Tierra Blanca 3 0 2 1 0 0 0 0 3 21 62 19 24
Quebrada Seca 23 3 4 1 0 3 0 12 11 25 272 17 37
Enganche 4 0 2 1 0 1 0 0 4 24 97 19 35
Cohetero 8 1 3 3 1 0 0 0 8 25 197 18 33
Pipiltepeque Abajo 14 1 5 2 2 0 0 4 10 23 233 18 32
Cuje 5 2 2 0 0 1 0 0 5 23 115 16 36
Las Lajas 4 2 2 0 0 0 0 0 4 20 79 16 23
Buena Vista 28 3 7 6 2 3 2 5 23 26 594 17 39
San Pablo 6 1 0 3 0 2 0 0 6 26.8 161 17 35
El Llano 2 0 0 1 0 1 0 0 2 30 60 24 36
Animas Lomas 43 10 10 9 5 3 0 6 37 24 875 14 38
Suchitán 52 14 18 5 9 3 3 0 52 24 1247 13 43
TOTAL 218 42 62 39 21 20 7 27 191 4659 13 43
12% 88% 24.4
Average
age

19%
29%
18%
10%
9%
3%
12%
Gráfico 11 Pregnant Women by Age Groups in ADP APAS
(April 2016) n=218
<19
19-23
24-28
29-33
34-38
>38
No info

ANNEX 3: ANTENATAL CARE ATTENDANCE OF PREGNANT WOMEN BY ADP
ANNEX 3A. NUEVO AMANECER
Table 14: Antenatal Care Attendance of Pregnant Women by Community in ADP Nuevo Amanecer (April 2016)
Community Total
Where do people go for ANC?
Local
health
center
%
Private
clinic
%
Family
clinic
% IGSS % Midwife % None %
No
info
%
Attends
more
than
one
%
Llano de la Virgen 14 8 57 1 7 0 0 0 0 2 14 0 0 0 0 3 21
Pamoca 24 8 33 2 8 0 0 1 4 8 33 2 8 0 0 3 13
El Cipres/Parcelas 16 5 31 1 6 0 0 0 0 8 50 1 6 1 6 0 0
El Carrizal 3 2 67 0 0 0 0 0 0 1 33 0 0 0 0 0 0
Estancia Vieja 10 7 70 0 0 0 0 0 0 2 20 1 10 0 0 0 0
San Martinero 22 13 59 0 0 1 5 0 0 0 0 2 9 0 0 7 32
TOTAL 89 43 48 4 4 1 1 1 1 21 24 6 7 1 1 13 15
% that attends
ANC 93.3

ANNEX 3B. TINAMIT
Table 15: Antenatal Care Attendance of Pregnant Women by Community in
ADP Tinamit (April 2016)
Community Total
Where do people go for ANC?
Local
health
center
%
Private
cinic
% None %
Estancia Rosario 23 17 74 0 0 7 30
Estancia Grande 35 35 100 0 0 0 0
San Jeronimo 37 34 92 3 8 0 0
Guates 29 28 97 0 0 1 3
TOTAL 124 114 92 3 2 8 6
% attends ANC 94.4
People who
attend ANC 117

ANNEX 4 CHILDREN UNDER 24 MONTHS BY ADP
ANNEX 4A. TOTALS
Table 16 Children Under 24 Months by ADP (April 2016)
ADP Total
Age (months)
Children
w/info
age
Average
age
Total *
average
age
0-12 13-24
No
InfoF M F M
Comapa 246 67 62 64 53 0 246 14.0 3448
Tinamit 369 92 112 66 99 0 369 11.7 4326
N. Amanecer 246 66 60 65 55 0 246 12.3 3034
APAS 607 66 60 65 55 10 597 12.9 7697
Total 1468 291 294 260 262 10 1458 18505
Average
age 12.7

ANNEX 4B. COMAPA
Table 17 Children Under 24 Months by Community in ADP Comapa
(April 2016)
Community Total
Age (months)
Children
w/ age
info
Average
Age
Total*
average
age
0-12 13-24 No
Info
F M F M
El Chinchintor 58 21 7 23 7 0 58 12.7 734
San Jose 32 13 10 3 6 0 32 10.5 337
San Juan 36 10 11 10 5 0 36 11.6 418
El Calvario 15 5 8 0 2 0 15 5.0 75
El Guayabo 4 0 1 2 1 0 4 15.8 63
El Cerrito 22 8 4 5 5 0 22 12.2 269
El Carrizo 53 12 12 11 15 3 50 11.1 556
San Francisco 31 5 13 8 5 0 31 14.4 447
El Comalito 30 8 9 8 5 0 30 12.0 360
El Tepenance 14 6 1 4 3 0 14 13.5 189
TOTAL 246 67 62 64 53 0 246 3448
Average
age 14.0
27%
25%
26%
22%
0%
Figure 12: Children Under 24 Months in ADP
Comapa (April 2016) n=146
0-12 F
0-12 M
13-24 F
13-24 M
No Info

ANNEX 4C. TINAMIT
Table 18 Children Under 24 Months by Community in ADP Tinamit
(April 2016)
Community Total
Age (months) Children
w/age
info
Average
Age
Total*
average
age
0-12 13-24 No
InfoF M F M
Estancia Rosario 68 28 23 8 9 0 68 8.5 581
San Jeronimo 59 12 30 6 11 0 59 10.0 591
Estancia Grande 204 35 48 47 74 0 204 13.6 2777
Los Guates 38 17 11 5 5 0 38 9.9 377
TOTAL 369 92 112 66 99 0 369 4326
Average
age 11.7
25%
30%
18%
27%
0%
Figure 13: Children Under 24 Months in ADPTinamit
(April 2016) n=369
0-12 F
0-12 M
13-24 F
13-24 M
No Info

ANNEX 4D. NUEVO AMANECER
Table 19 Children Under 24 Months by Community in ADP Nuevo Amanecer (April
2016)
Community Total
Age (months)
Children
w/ age
info
Average
Age
Total*
average
age0-12
13-24
No
InfoF M F M
Llano de la Virgen 34 9 13 9 3 0 34 10.6 362
Pamoca 59 18 13 15 13 0 59 11.9 701
Cipres/ Parcelas 69 19 14 16 20 0 69 12.8 882
El Carrizal 7 4 3 0 0 0 7 6.6 46
Estancia Vieja 29 5 7 11 6 0 29 14.8 428
San Martinero 48 11 10 14 13 0 48 12.8 615
TOTAL 246 66 60 65 55 0 246 3034
Average
age 12.3
27%
24%
27%
22%
0%
Figure 14: Children Under 24 Months in ADP Nuevo
Amanecer (April 2016) n=246
0-12 F
0-12 M
13-24 F
13-24 M
No Info

ANNEX 4E: APAS
Table 15 Children Under 24 Months by Community in ADP APAS (April 2016)
Community
Total
Age (months) Children
w/ age
info
Average
age
Total*
average
age
0-12 13-24
No
InfoF M F M
Cerro Gr. Barreal 28 5 4 10 9 0 28 14.0 391
Cerro N. Esperanza 34 10 13 5 4 2 32 9.4 300
Pilas 21 6 6 4 5 0 21 11.3 237
Tierra Blanca 12 0 3 3 4 2 10 15.6 156
Ceibita 5 2 1 2 0 0 5 10.6 53
Quebrada Seca 39 10 18 2 8 1 38 9.7 369
Enganche 42 13 10 11 7 1 41 12.5 514
Cohetero 29 8 4 6 10 1 28 12.8 357
Pipiltepeque Abajo 30 5 8 11 6 0 30 11.3 338
Cuje 24 4 8 4 8 0 24 13.0 313
Lajas 21 8 9 3 1 0 21 7.8 164
Buena Vista 80 15 16 21 28 0 80 14.6 1168
San Pablo 9 5 0 2 2 0 9 11.1 100
Llano 13 2 4 3 3 1 12 12.1 145
Animas Lomas 132 34 30 31 36 1 131 12.7 1670
Suchitan 88 10 8 32 37 1 87 16.3 1422
TOTAL 607 137 142 150 168 10 597 0.0 7697
Average
age 13
22%
23%
25%
28%
2%
Figure 13 Children Under 24 Months in ADP APAS
(April 2016) n=607
0-12 F
0-12 M
13-24 F
13-24 M
No Info

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